Migraine headache can be one of the most debilitating chronic conditions. Frequent headaches often remove the patient from their normal activities of daily living, be it work, caregiving, or basic functional self-care routines. Nearly 11% of adults are affected worldwide.[1] An assortment of symptoms can accompany headache including sensitivity to light, nausea, and/or vomiting. A large percentage of migraine-sufferers are warned of an impending migraine by an “aura,” which can be classified as sensory disturbances, be it visual spots or flashes in eyes, tingling or numbness of body, or even speech problems. Another form of chronic headache includes cluster headaches, or "suicide headaches" which are periodic and can occur 1-3 or up to 8 times per day. The timeframe in which they last, or the “cluster period” can last from 2 weeks to 3 months. Headaches may go into remission or disappear for months or years. Often, these debilitating headaches can awake a person from sleep 1-2 hours after going to bed. We see patterns with cluster headaches, either following the circadian rhythm or time of year. Unfortunately for these patients, the actual pain can be 100 times more intense than a migraine headache. Trigeminal Neuralgia is a condition that causes extreme and sudden facial pain, usually one sided. Attacks are intense and feel like an electrical shock lasting seconds to minutes, often triggered by mechanical touch like brushing your teeth or light touch to the cheek. As a naturopathic doctor, my focus is not primarily on pain management. We seek to treat the cause of symptoms and conditions. Often I see the cause of migraines to be influenced by stress and/or hormone imbalances. Many women notice a connection to their menstrual cycle. Others find that food sensitivities can be a major trigger. Workup and treatment for migraines, cluster headache, and trigeminal neuralgia are not an overnight approach to cure. Sometimes the patient can be quite resistant to cure even with resolve of causative imbalances. Though challenging to treat, we have so many tools to offer. New Treatment Offering! My colleague at Prosper Natural Health, Dr. Molly Force, and I are now offering an incredible treatment for sufferers of chronic migraine, cluster headaches and trigeminal neuralgia. This treatment is called a “Sphenopalatine ganglion (SPG) block,” and it has been so impressive in its effects on chronic headache and facial pain, providing an 80% success rate! [2] The SPG is a large group of nerve cells that are part of the trigeminal nerve bundle, innervating autonomic, motor and sensory nerves. It is located behind the middle turbinate and maxillary sinus on each side of the face. The procedure takes roughly 10 minutes and can have immediate effects. The patient lies down with their head just below their shoulders. The physician then applies a small amount of lidocaine up the nostrils with a sphenocath, allowing it to pool and numb the SPG for 5 minutes. The patient is then able to sit up and get on with their day without side effects. The goal of the SPG block is to break the pain cycle. The results of the block may be temporary or provide lasting effects depending on the individual. Some patients need to be retreated after 6 weeks or seasonally. We are thrilled to provide SPG blocks in office, providing “reset button” for the nerves that are affected in migraine, cluster headache and trigeminal neuralgia.[3][4] Call the office today to schedule an appointment! 360-385-5375 [1] World Health Organization. 2011.http://www.who.int/mental_health/management/atlas_headache_disorders/en/[Google Scholar] [2] Robbins M. S., Robertson C. E., Kaplan E., et al. The Sphenopalatine Ganglion: Anatomy, Pathophysiology, and Therapeutic Targeting in Headache. 2016;56(2):240–258. doi: 10.1111/head.12729. [PubMed] [CrossRef] [Google Scholar] [3] Mojica J1, Mo B1, Ng A2. Sphenopalatine Ganglion Block in the Management of Chronic Headaches. Curr Pain Headache Rep. 2017 Jun;21(6):27. doi: 10.1007/s11916-017-0626-8. [4] Rosso C1, Felisati G2,3, Bulfamante A1, Pipolo C4. Cluster headache: crosspoint between otologists and neurologists-treatment of the sphenopalatine ganglion and systematic review. Neurol Sci. 2019 Mar 16. . doi: 10.1007/s10072-019-03796-5
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AuthorDr. Alicia McCubbins is a naturopathic physician who strives to educate, motivate and inspire. Please feel free to share your thoughts or questions so that we may collectively grow through knowledge. Archives
January 2020
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